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KNDU: MBBS for the rich, crumbs for the poor

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By RAMYA KUMAR

A regular day at work. A medical student, Niluka (not her real name), comes to my office to discuss the presentation she is due to make at a research symposium. In the middle of our meeting she is in tears. Her mother, a single mother, who works as a security guard in remote Polonnaruwa, cannot afford her boarding fees as she has to cover her sister’s A/L tuition classes, as well as her brother’s medicines for a recent health issue. Niluka is unable to focus on her presentation because she is worried about her financial situation. She has a year and half to go.

This is the picture of Free Education that many do not see, of students struggling to make ends meet. Such stories are commonplace at our non-fee levying state universities; as Sumathy Sivamohan wrote recently, “free education does not serve everybody equally, but over the years and across decades, it has come to represent the hope of a vast majority for a better place in society.” However, this aspect of Free Education is obscured by images of protesting students “wasting tax-payers’ money,” constructed by the media in the service of the state. While Colombo-based elites (and others) may be duped into seeing the Kotelawala National Defence University (KNDU) Bill and military repression as solutions to the problems in higher education, this article explores what the Bill really means, especially its implications for medical education.

No vision, no imagination

Free Education, despite its marginalisations and exclusions, is etched in our nation’s consciousness, so much so that governments have been reluctant to overtly dismantle the public education system. Instead, they have stealthily underfunded the system, while incentivising expansion of private education. With inadequate public investment, the state universities under the UGC are floundering to service demand, while the fee-levying Kotelawala Defence University (KDU) and non-state fee-levying higher educational institutions, such as SLIIT, receive state subsidies to finance infrastructure as well as student loans.

Fee-levying universities are simply not affordable for the vast majority in this country. To flourish, they require public-financing, both for their establishment and for student loans, to make them accessible to the masses. While escalating investment in KDU and private fee-levying universities through public funds, the government has adopted a zero-investment policy for state universities under the UGC and increased admissions by a third, this year. The fallout of increasing admissions without budgetary allocations is most felt by universities in peripheral districts, already running on meagre resources.

A government’s vision for education is inextricably linked with its economic policy. While lacking a credible vision for education, successive governments have been equally unimaginative in attempts to improve the economy. Sri Lanka relies on imports for day-to-day essentials, such as lentils, pulses, and milk, with little investment in agriculture or agro-industries for value addition. Meanwhile, billions of rupees are lost in tax incentives to attract (elusive) foreign direct investment, including in education. The Board of Investment expanded its purview to include the social sector in the 1990s, essentially opening education to the global market. The latter has changed the landscape of education in the country with international schools, private colleges and other higher education institutions proliferating in the decades since, and creating parallel systems of education for students from rich and poor families.

Enter KNDU

Faced by mounting debt, the government is desperately looking for avenues to build up its foreign reserves. In 2019, the incumbent government proposed a “free education investment zone” to attract investment from “top international universities,” with accompanying tax exemptions, yet another scheme to subsidise the private sector through public funding. With COVID-19, the plans for the investment zone fell by the wayside. However, just a few years after the SAITM debacle, the government is once again looking to expand private medical education, this time through the KDU.

In 2019, the incumbent President’s manifesto, which is the government’s policy framework, stated that “steps will be taken to expand the Kotelawala Defence University” (p.22). Why KDU? Because the majority of its students are enrolled on a fee-levying basis through mechanisms outside the UGC’s Z score-based system. Although seemingly catering to the military, a closer look at the statistics presented on the website of KDU’s Faculty of Medicine, indicate that the number of medical students recruited doubled, and then tripled, once the faculty began to enroll “non-military foreign students.” As recruitment was limited to foreign students, albeit loosely defined, KDU did not encounter too much controversy.

The KNDU Bill proposes to build a parallel militarised university system, and alternatively, a change to the Universities Act of 1978 aims to bring KDU under the purview of the UGC, as a university for a “specific purpose.” Clearly, the appeal of KDU and other “specific purpose” universities is not their potential to strengthen Free Education. That these reforms will increase the military’s involvement in higher education has been the focus of debate in recent weeks, but less attention has been paid to their implications for education opportunities for students like Niluka, and their potential impact on medical education.

‘MBBS Kada’

Both the proposed KNDU Bill and the amendment to the Universities Act can be viewed as attempts to create the conditions for the expansion of fee-levying MBBS degree programmes, which have been resisted since the days of NCMC. The KNDU Bill will give legal authority for KNDU to recognise and affiliate other institutions to KNDU, bypassing the UGC as well as the Sri Lanka Medical Council’s minimum standards. The Bill will ultimately result in the proliferation of poorly regulated ‘MBBS kada,’ and a decline in the overall standards of medical education.

Even the Association of Medical Specialists (AMS), a body not averse to private education, has made the following statement regarding the KNDU Bill: “On principle, the AMS is not against quality fee levying medical education…if it is regulated and monitored by the UGC and the Sri Lanka Medical Council. However, lack of proper process and transparency will prevent the establishment of such fee levying institutions in Sri Lanka.”

Could expanding medical education in this manner present opportunities to address problems in the health sector, such as the regional maldistribution of physicians?

First, if KNDU and its affiliates aim to attract international medical students, it is unlikely that these graduates would serve in Sri Lanka.

Second, as the Bill will enable KNDU to admit local students, if we assume the current fee structure of upwards of Rs. 1 million per year for the MBBS programme, the KNDU medical students would represent the elite who are more likely to immigrate to greener pastures.

Third, if the government intends to broad-base MBBS degree programmes, they would need to offer hefty student loans to our students. Evidence from other countries suggests that medical graduates with student loans are more likely to opt for higher paying specialties rather than work in primary care, and less likely to serve in rural areas.

It is therefore unlikely that the KNDU Bill would contribute towards advancing the health sector, except perhaps through its military cadets, who would most likely work for the Ministry of Defence and not the Ministry of Health.

Student loans may have other unintended consequences. Despite private practice being widespread, many doctors, especially women non-specialist doctors, do not engage in private practice. In fact, general doctors from peripheral districts often do return to their districts, although they may remain in urban centres owing to the poor education facilities available to children in remote rural areas. These doctors make up the physician workforce in base hospitals and above, as well as in the preventive sector, in all parts of the country. Having to repay a student loan may drive such doctors to remain in districts, where private practice is more available and lucrative, intensifying the regional maldistribution of physicians.

Crumbs for the poor

What of students like Niluka in the non-fee levying state university system? A quick perusal of the website of KDU’s Faculty of Medicine indicates that brain drain may have already commenced. Imagine the fate of our non-fee levying state medical faculties with the mushrooming of ‘MBBS kada’ across the country? They will inevitably offer higher salaries, as does KDU, attracting without any outlay teachers whose training was subsidised by state universities. Furthermore, as reported in the media, KDU has already seen massive state investment, much of it in its teaching hospital, far beyond investments in any single university or faculty of medicine under the UGC. The fate of medical education at non-fee levying state universities does not need to be spelled out here. With their weakening, the demographics of students who enter medicine are sure to change, with fewer and fewer opportunities for students like Niluka, not to mention the broader implications for medical education and the healthcare system.

Let’s stand together to protect Free Education and Free Medical Education!

 

(The writer is attached to the Department of Community and Family Medicine, Faculty of Medicine, University of Jaffna).



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Opinion

‘Nitro Raja’: Magic Fertiliser arrives!

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By Dr PARAKRAMA WAIDYANATHA

The consignment of nano urea, much spoken about produced by Indian Farmer Fertiliser Corporation (IFFCO}, had just arrived! Locally it is named “Nitro Raja!” Can the imported Raja settle our fertiliser woes, where the ‘local Raja’ has hitherto failed?

What is nano urea, many people ask! For the layman it may best be described as something akin to “Seeni- polkohu” or “Bombai-motai”, where sugar particles are attached to a fibrous material. Similarly, in nano urea, the urea molecules are attached to oligosaccharide (examples, starch and sugar) molecules. This greatly enhances the efficacy of the applied urea to crops.

The advantage is that, whereas urea when applied to the soil, often much of it is wasted through leaching, run-off in rain water and vaporisation, losses are very small with the nano formulation. Even normal urea if applied to plants as a leaf spray in good weather, the losses are far less than application to the soil. Up to a maximum of 5% of chemical nutrients can be applied as foliar spray, and in fact urea is, for example, routinely applied in tea plantations usually mixed with zinc sulphate, which research has reported, to boost crop yields substantially.

Regrettably the imported consignment apparently is exclusively for rice cultivation. Is it because the tea growers were not as vociferous and violent as the rice farmers in their demonstrations and ministerial effigy-burning? Ideally, for the tea growers, too, urea is critically important. As most would have applied all nutrients over the years, the soil reserves of nutrients should suffice to tide over an year or more except for nitrogen, the most yield determining nutrient; and the current huge tea crop losses could have been saved, if at least urea in whichever form were supplied to the tea industry.

The critical issue is, however, whether at the recommended rate, the imported nano urea could effectively meet the crop nitrogen demand. It is imported in 500 ml bottles and each bottle content, the advertisement says, is equivalent to a 50 kilo bag of normal fertiliser urea. Nevertheless, it is further stated in the advertisement that the contents has a nitrogen(N) concentration of only 4%, whereas normal urea has 46%.

Meeting Demand?

Let us see whether the supplied nano urea can meet the crop nitrogen demand at the prescribed application rate. The national average yield of rice is now 5 tons /hectare. Therefore, an average rice crop by way of grain and straw removes about 80 kg/ha, and the normal rate of application of nitrogen for a good rice crop is 100kg/ha . So, in whatever way the crop is fertilised (with nano urea or normal urea) a 5 ton rice crop/ha should remove a minimum of 80 kg of nitrogen. Theoretically, however, the recommended nano-urea formulation imported can only provide 20 grams of nitrogen per 500 ml bottle, and to provide the requisite nitrogen of 80kg/ha to the crop, therefore, 4000 such bottles should be applied! The cost of a 500 ml bottle is reported to be Indian Rs 240, which is about local Rs 500. Theoretically then, the nano fertiliser per crop to provide the entire crop nitrogen requirement should cost two million rupees! Can this nano urea then practically meet the total crop nitrogen demand ?

The crux of the matter is that, in India, where nano urea is used, usually a basal application of conventional urea is made to the crop, and nano urea is only sprayed at mid- maturity as a foliar spray for boosting the crop.

The other serious concern is that when nano urea is spayed as the crop is growing, the emerging weed growth in the absence, now, of the two standard herbicides used in rice, one before crop emergence (usually Propanil) and the other ( MCPA )when the crop is in early growth(post emergent), could be substantial. Nearly 95% of the rice growers broadcast seed, and hand weeding is difficult in such crops. Row seeding is highly labour demanding and row seeders are costly. Much of these weeds are highly competitive C4 grasses and sedges, which too will benefit from the foliar nano urea spray and increase the competitiveness, reducing the crop yield!

One of the growing concerns today, globally, in the fertiliser scenario is, not whether it is organic or chemical, but with the grain production anticipated to increase by at least 40% in the next decade and 60% of the nitrogenous fertiliser used for it, the devastating environmental AND pollution issue . Many argue the answer is in cutting down meat consumption as bulk of the grain in the developed world is used as animal feed!

However, there is already technology generated for improving N management practices at the farm level, and nitrogen uptake efficiency (NUE) increases of 36% and 32% have been achieved in the U.S and Japan respectively in the last few decades; one of them being nano fertilisers. With novel plant breeding and fertisier technologies many scientists envision reaching 90-100% NUE in the near future.

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Distorting Buddhism

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By Dr Upul Wijayawardhana

Two recent glaring distortions of the life of the Buddha, in Sinhala newspapers, has compelled me to pen these thoughts. Contrary to the high standards maintained by most of the English language newspapers, I have been appalled by the journalistic standards of some of their Sinhala counterparts. True, Sinhala is a difficult language but if it is to be simplified, it should be done with the consensus of experts than by gross disregard of typography at the whims and fancies of editors. In spite of this, we love to watch programmes surveying Sinhala newspapers for a multitude of reasons and it has become a daily routine in our lives though, unfortunately, some of these programmes have of late become crude political tools and means for the glorification of some presenters. Headlines in Sinhala newspapers are a better indicator of ‘how the wind is blowing’ and, more importantly, the sharpest ‘weapon’ attacking politicians, sarcasm, is at its best in the poems and cartoons. Indian Prime Minister Modi honoured Sri Lanka and recognised the importance of Sri Lanka in Buddhism, by inviting a delegation from Sri Lanka to be the first to land officially at the newly developed Kushinagar International airport. A delegation consisting of 100 high-ranking Buddhist monks and some Ministers, led by Minister Namal Rajapaksa, arrived there on the inaugural SriLankan Airlines flight for the opening ceremony on Wednesday 20th, the Vap full moon Poya day.

A headline in one of the Sinhala newspapers, on 20th, stated that an airport in Prince Siddhartha’s place of birth was to be opened that day! How could the reporter confuse the place of Buddha’s Parinibbana with the place of birth Lumbini, which is in Nepal? The following day, another Sinhala newspaper, reporting on the opening ceremony with a beautiful photograph of our Monks walking in procession, had a poem as the headline. Unfortunately, the poem stated that Sangha with “Nava Arahadi Guna” were in procession. Even a child knows that the correct term is “Nava Arahadi Budu Guna” which refers to the Nine Noble Qualities of the Buddha! Considering that on many an occasion our editor has saved me from embarrassment by correcting inadvertent mistakes I have made; I find it puzzling that these glaring mistakes were not picked up by the respective editors. In many recent ‘Quiz shows’, Muslim children have shown surprising depth of knowledge about Buddhism and the life of the Buddha. Considering this, is it not appalling that reporters and headline writers make such inexcusable mistakes? To add insult to injury, not even the newspaper reviewers picked up on these howlers. Perhaps, they do not understand what a review means! I am beginning to wonder whether there are deliberate attempts at distortion as, for quite some time, there have been spurious claims made on the life of the Buddha, often by the members of the Sangha itself.

Instead of following the path the Great Teacher showed, some of them want to bolster their argument that Sri Lanka is the birthplace of the Buddha, in spite of confirmed archaeological evidence to the contrary. Recently, a friend of mine forwarded what appeared to be a clip of a news item, titled “The lawsuit uncovering the world’s biggest colonial scandal – Rediscovery of Bhudha’s true home land”. It stated that a lawsuit had been filed in the UK courts, by a Buddhist monk living in Norway, requesting that Sri Lanka be declared the place of birth of the Buddha and compensation be paid for British archaeologists distorting facts. This took me completely by surprise as I had not heard of any such action and my suspicions were aroused because there was no indication what the news channel was. I sent the following message to my friend:

“Did you forward this because you believe in what is stated?” and I got a vague reply. Fortunately, another friend forwarded the same message with additional information in the form of an audio clip, addressed to a Nayaka Priest in Sri Lanka, by a Bhikkhu living in London wherein he states that there is no such action pending and the person referred to is a person connected to the LTTE, living in Norway, pretending to be a Buddhist priest! When I googled to get details of the organisation this Norwegian Bhikkhu represents, there was no information about the person concerned, but there was a page seeking contributions!Maybe, this is an imposter out to make a fast buck, but we have enough ‘robed-men’ demonstrating behaviour in total contrast to the teachings of the Buddha. During the teacher’s strike, one of these who leads a nurse’s trade union, though not having any nursing experience at all, took the leader of the teacher’s union, who has not done even a day’s teaching, to the Prime Minister for a settlement.

Then there is the dirty spectacle of two politicians in robes fighting for a parliamentary seat! One of the fundamental teachings of the Buddha is “Tanhaya Jayati Soko”—Greed begets sorrow—but their greed seems endless! Interestingly, one these distinguishes himself by being in all the major parties and is now prepared to go to courts to retain his seat.We have Sangha Nayakas, “Adhi Karana” Judicial Sangha Nayakas but nothing seems to be happening to these men in robes who are a disgrace, to say the least, to the Buddha. I am told that an ‘Adhi Karana’ Sangha Nayaka for the UK also has been appointed recently. I cannot understand why all these Bhikkhus are driven by greed for positions. Perhaps, it is excusable if they at least serve a purpose. Buddhist principles are distorted and destroyed whilst those in authority are in a slumber. I do tender my humble apologies to many Buddhist monks around the world who render a great service in the true spirit of the Dhamma, and do hope these comments, in no way, hurt them. In fact, we are very fortunate to have three Venerable Monks in our local Vihara whom we can worship without any hesitation. I often wonder, whether the future of Buddhism is in the West!

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Running against the Wind: Remembering Engineer Lalith Vidanapathirana

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Phidias, the great sculptor was immersed in work. It was 447 BC, and Phidias was given the mission to sculpt a massive statue of the goddess of wisdom and war –Athena by a statesman of Athens – Pericles. He was working high above ground, behind the head of Athena for a long time. A passerby, who knew little about sculptures wanted to ridicule Phidias and shouted at him… ‘’O great sculptor Phidias..! Who will ever want to know what kind of fine works you are creating up there..? No one is going to climb this massive statue and have a look”. Phidias had a simple answer. “I will…” Men of this nature, who will put everything… heart and soul to a task, given to them when no one is looking are rare. Yet, we at Ceylon Electricity Board (CEB) are fortunate to have many such men among us, at every level of the organisation. Men who will silently work under trying conditions to keep the country lit up and active, without craving for attention and glory. Leaving the master sculptor Phidias in the distant past, let me tell the story of one such man from the not so distant past.

I first encountered him at the Deputy General Manager’s office of CEB in Galle in 1987. He was an energetic Construction Engineer and we were a group of trainees from University of Moratuwa, two years into the degree programme. We were comfortably seated around a table, solving various problems. Suddenly we heard a strong voice, which appeared to carry a lot of authority. What are you trainees doing here? It was a command that was so direct and clear. We had no business indoors; we should be outdoors. Thus begun a spell of constant engagement in various projects in and around Galle. We learnt much about electricity distribution and about what to expect in a career as electrical engineers.

Time passed and we met again in 1997 now both of us working for the same organisation, CEB, at a training workshop on Power System Protection. He caught my attention as the most active participant shooting so many practical questions. He instantly recognised me and exclaimed that it is so very nice to have me in CEB. Then our paths crossed again in 2006, this time at a training workshop on wind energy where I was the coordinator. I remember his enthusiastic participation, posing practical questions at the foreign resource persons. Among the trainees, he benefited more than all the younger participants I reckoned, even at that early stage of wind power development in Sri Lanka. CEB then had only 3 MW of capacity from wind power and now, 103 MW capable of providing the annual electricity requirements of more than 400,000 Sri Lankan homes.

This story is about the Engineer Lalith Vidanapathirana who made a massive contribution to make it happen on the ground.

Then he went on overseas leave to assist the newly formed Iraqi Government to rebuild Iraq’s electricity infrastructure. This was a UNDP assignment which benefited Iraq, as he was able to fully develop teams capable of shouldering the massive reconstruction burden, after years of conflict. The battered Iraqi engineers and technicians had great respect and love to Lalith. He rebuilt their skills from ground zero to re-establish and operate the electricity network in those conflict affected regions in Iraq. Most of the tasks he undertook were way out of the narrow scope of the UNDP consultants’ brief. With Lalith’s leadership. Iraqi men were ready to do it themselves.

When Lalith returned to Sri Lanka, I worked with him in a boundary metering project, and we had a lot of time together. This is when we attempted to scale up the success of the first wind power project in Hambantota under the guidance of Mr. Samarasinghe and Mr. Ayiradasa, as a 30MW wind project in Kalpitiya. We did everything in our capacity to implement this, but it wasn’t a success.

During these days I learnt about his early career at Samuel & Sons, the famed engineering outfit of colonial heritage, where he practiced his heavy engineering. I was told that he was a formidable force in many construction projects implemented by Samuel & Sons. With this knowhow, he was a much sought after person in CEB. He caught the attention of his superiors as one of those ‘doers’ who fronted difficult assignments. Actually, it was all Lalith was about – leading. Be it the transmission lines destroyed by insurgents or distribution systems torn apart, he was willing to lead from the front.

Then on a beautiful day in 2016, Lalith called me and asked whether I would join him to build the wind power plant in Mannar. By that time my colleagues Kumara and Thusitha has done a sizable job in Mannar, initiating all-important bird survey and other pre-project development work. I told Lalith, I will join if you agreed to lead the project and train young engineers. Lalith, without a hint of hesitation, agreed.

Here we were, once again in the same boat, but not in the calm seas as during the boundary metering project. Had nothing to start with, but Lalith being the doer, managed to amass all the resources required to initiate this task within a few months. He was very active, and barged into offices of his superiors with impunity and sometimes even to the Board room, to get things done. Not for him, but for the project, for public good.

He stood by his team through struggles and fought for what he believed in with the sincere motive to get things done. He gave all of us absolute freedom to work; in the way we liked, but at his pace. So, we accomplished all pre-project development tasks within a short period of time and more importantly was able to build and develop capacity within the team. We saved a few million Dollars and a whole year of project gestation period because he trusted our ability. He was truly an engineer. He never minced his words or give way to the opponents, standing firm for a public cause, taking a resolute stand on issues. We learnt many things from Lalith, engineering and otherwise, all of which cannot be enumerated here.

The 103 MW, the largest-ever wind power plant in Sri Lanka, was about to enter the construction phase. Then came the devastating news about a serious illness he had developed. The illness reduced his mobility, but he made it a point to attend all important events. He had a dream, just to see one turbine erected “before I go” he would tell us. He did not wait that long, he only lived to see the selection of a leading turbine manufacturer as the main contractor. However, he fulfilled his dream to see his son’s graduation ceremony, albeit his failing health. He left us on 22nd October 2018.

Mannar wind power project is now a reality. I stood diminutive under the massive wind turbines standing tall on the Mannar shoreline and running against the wind, which reminded me of the struggles made by many unsung heroes who genuinely contributed to it. As the sun disappeared beyond the horizon, painting the Western skies in crimson, the beautiful song by Bob Seger started playing deep within me…

We were running against the Wind…

We were young and strong, we were running against the Wind…

Well, I am older now but still running against the Wind…

against the Wind… against the Wind… against the Wind…

This by all means is a feeble attempt to share my memories of a man of integrity, dedication and practical approach. It is also an attempt to appreciate and recognise the lives of many other Sri Lankans, who are still running against the Wind. It is also to remind the young, not to get swept away by Winds. For his impressive run of life was always against the Wind.

May he attain the supreme bliss of Nirvana.

Ajith Alwis

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